To determine the prognostic value of the treadmill exercise test, we evaluated 2842 consecutive patients with chest pain who had both treadmill testing cardiac catheterization. The population was randomly divided into two equal-sized groups and the Cox regression model was used in one to form a treadmill score that was then validated in the other group. The final treadmill score was calculated as follows: exercise time - (5 X ST deviation) - (4 X treadmill angina index). Using this treadmill score, 13% of the patients were found to be at high risk; 53%, at moderate risk; and 34%, at low risk. The treadmill score added independent prognostic information to that provided by clinical data, coronary anatomy, and left ventricular ejection fraction: patients with three-vessel disease with a score of -11 or less had a 5-year survival rate of 67%, and those with a score of +7 or more had a 5-year survival rate of 93%. The treadmill score was useful for stratifying prognosis in patients with suspected ...
I have suffered from panic attacks for over 20 years. I am 55 years old. I recently went in for my routine physical and had a panic attack during the treadmill stress test. The Cardiologist said I h...
TY - JOUR. T1 - Long-term outcome of patients with intermediate-risk exercise electrocardiograms who do not have myocardial perfusion defects on radionuclide imaging. AU - Gibbons, Raymond J. AU - Hodge, David O.. AU - Berman, Daniel S.. AU - Akinboboye, Olakunle O.. AU - Heo, Jaekyeong. AU - Hachamovitch, Rory. AU - Bailey, Kent R. AU - Iskandrian, Ami E.. PY - 1999/11/23. Y1 - 1999/11/23. N2 - Background - The appropriate management of patients with intermediate- risk Duke treadmill scores is not established. The purpose of this study was to determine the long-term risk of subsequent cardiovascular events in patients with an intermediate-risk treadmill score who do not have myocardial perfusion defects on radionuclide imaging. Methods and Results - The existing databases of the nuclear cardiology laboratories of 4 academic institutions were searched retrospectively. A total of 4649 patients were identified who had intermediate-risk Duke treadmill scores (- 10 to 4), normal or near- normal ...
Introduction: Cardiovascular fitness is an important goal in cardiac rehabilitation (CR) programs and is predictive of outcomes. We sought to determine the utility of a novel clinical treadmill score in determining prognosis of coronary artery disease (CAD) patients after CR. Methods: Demographic, clinical and exercise data of 262 patients (mean age 55.8 ± 10.1 years) who completed an outpatient CR program were analyzed. The FIT treadmill score was determined prior to program initiation and after completion. Patients were classified according to risk category using the FIT scores after CR completion and were followed up for the occurrence of 10 year all cause mortality. Results: On median follow up of 10.3 years, 52 patients died. An improvement of the FIT treadmill score by 18.2 points was associated with a 21% reduction in mortality (multivariate-adjusted Hazard Ratio 0.79, 95% CI 0.56-1.08, P≤0.05). Kaplan-Meier survival curves showed increased occurrence of mortality in the high-risk group. After
This page includes the following topics and synonyms: Exercise Stress Test, Exercise Electrocardiography, Duke Treadmill Score, Exercise Treadmill Test.
TY - JOUR. T1 - Treadmill Exercise Test and Pharmacologic Stress Echocardiography for Womens Coronary Artery Disease. AU - Lee , Gawain Shih-I. AU - Huang , Lien-Chi. AU - Kuo, San-Dar. AU - Liu, Ju-Chi. AU - Chang, Nen-Chung. PY - 2008/9. Y1 - 2008/9. KW - Pharmacologic stress echocardiography. KW - Duke activity status index questionnaire. KW - Duke treadmill score. UR - http://readopac2.ncl.edu.tw/nclJournal/search/detail.jsp?sysId=0006563988&dtdId=000040&search_type=detail&la=ch. M3 - Article. VL - 2. SP - 133. EP - 137. JO - 臺灣心臟超音波學會雜誌. JF - 臺灣心臟超音波學會雜誌. IS - 3. ER - ...
Background: Submaximal exercise tests use heart rate responses to low-to-moderate intensity activity in order to predict cardiorespiratory fitness (VO2max). Currently used tests may be inappropriate for obese populations as obese women have altered heart rate responses to exercise. The purpose of this study is to test the validity of the Modified Bruce Protocol submaximal treadmill test in obese women. Methods: Normal-weight (NW) women and obese (OB) women completed the Modified Bruce submaximal treadmill test (to predict VO2max using previously validated equations) and a maximal graded exercise test on a treadmill using the Standard Bruce Protocol (to obtain an actual VO2max) on two separate occasions. The relationships between actual and predicted VO2max values were analyzed using correlation coefficients. Results: 9 NW (age: 23.1 ± 8.0 y, body fat: 23.5 ± 4.9%) and 9 OB (age: 22.0 ± 4.8 y, body fat: 36.9 ± 4.4%) women participated. Actual and predicted VO2max values were not correlated ...
In this study we assessed whether various responses to exercise testing could be quantified in order to derive the probabilities of presence of coronary disease, and if present, to assess its severity. A treadmill score based on the exercise response was determined in 405 patients who had both treadmill tests and coronary angiograms. The score was derived using discriminant function analysis, by weighting and combining depth and configuration of ST depression (downsloping, horizontal or slowly upsloping), timing onset and duration of ischemia, grading ventricular arrhythmias, heart rate and blood pressure change, coexistence of exercise-induced chest pain and sex. The treadmill score was effective in detecting coronary disease (lesions with an greater than or equal to 50% narrowing), with a predictive accuracy (PA) (probability that a subject manifesting a positive test has disease) of 87%, a true negative rate (TNR) (probability of a subject with a negative test having no disease) of 80%, and ...
A total of 9,569 consecutive patients were included, of which 46.8% were women. Overall, exercise capacity and heart rate recovery were significantly associated with all-cause death. Exercise capacity, chest pain, and ST-segment deviations were significantly associated with subsequent MI. In general, the relationship between ETT variables and outcomes was similar between men and women, except for abnormal exercise capacity, which had a significantly stronger association with death in men (hazard ratio [HR], 2.89; 95% confidence interval [CI], 1.89-4.44), but not for women (HR, 0.99; 95% CI, 0.52-1.93). In contrast, chronotropic incompetence had a significantly stronger relationship with MI for women (HR, 2.79; 95% CI, 0.94-8.27) than for men (HR, 1.29; 95% CI, 0.74-2.20).. ...
This randomised, controlled study showed that myocardial ischaemia in hypercholesterolaemic patients with normal coronary arteries, as indicated by ST segment depression during exercise stress tests, can be ameliorated by cholesterol lowering drug treatment. Statin treatment reduced the number of patients with positive exercise test results and improved exercise endurance (higher maximum heart rate and lower maximum diastolic blood pressure). In contrast, diet alone produced little change in cholesterol and did not improve myocardial ischaemia induced by exercise testing. The beneficial effect of lowering plasma cholesterol concentrations by statin treatment may be related to normalisation of coronary endothelial function.. Research has shown that coronary risk factors, such as increased plasma LDL cholesterol20 21 and oxidised LDL,22adversely affect endothelial vasomotor responses in humans. Intracoronary infusion of acetylcholine has been shown to dilate normal human coronary arteries by ...
BACKGROUND:Exercise testing has limited efficacy for identifying coronary artery disease (CAD) in the absence of anginal symptoms. Exercise echocardiography is more accurate than standard exercise testing, but its efficacy in this situation has not been defined. We sought to identify whether the Duke treadmill score or exercise echocardiography (ExE) could be used to identify risk in patients without anginal symptoms. METHODS:We studied 1859 patients without typical or atypical angina, heart failure, or a history or ECG evidence of infarction or CAD, who were referred for ExE, of whom 1832 (age 51+/-15 years, 944 men) were followed for up to 10 years. The presence and extent of ischaemia and scar were interpreted by expert reviewers at the time of the original study. RESULTS:Exercise provoked significant (>0.1mV) ST segment depression in 215 patients (12%), and wall motion abnormalities in 137 (8%). Seventy-eight patients (4%) died before revascularization, only 17 from known cardiac causes. The ...
BACKGROUND: Important modern prognostic markers such as heart rate recovery (HRR), chronotropic index, delayed systolic blood pressure (SBP) response and Duke treadmill score (DTS) have been evaluated by treadmill exercise testing. Their value in bicycle exercise testing is unclear. METHODS: Patients (n=211, age 64+/-10; 75% male) with known or suspected coronary artery disease randomly underwent either bicycle (n=105) or treadmill (n=106) exercise electrocardiography. They were matched for age, gender, body mass index, hypertension, smoking, lipid status, prevalence of diabetes, medication, haemoglobin level, extent of coronary artery disease and left ventricular ejection fraction. RESULTS: Despite a higher peak heart rate (pHR) patients stressed by treadmill had a slower drop in HR during the early phase of recovery with a significantly higher rate of abnormal HRR (pHR; HR 1 min into recovery | or =12 bpm) with 37% in treadmill versus 19% in bicycle (P=0.004). Abnormally delayed SBP response [(SBP 1
To determine if patterns of ST depression or elevation during exercise testing provide reliable information about the location of an underlying coronary lesion, we studied 452 consecutive patients with one-vessel disease who underwent treadmill testing. Exercise ST changes were classified as elevation or depression and by lead groups involved. The ST depression occurred most commonly in leads V5 or V6 regardless of which coronary artery was involved. In contrast, anterior ST elevation indicated left anterior descending coronary disease in 93% of cases, and inferior ST elevation indicated a lesion in or proximal to the posterior descending artery in 86% of cases. Furthermore, anterior ST elevation in leads without diagnostic Q waves usually indicated a high-grade, often proximal, left anterior descending stenosis, whereas anterior ST elevation in leads with Q waves usually indicated a totally occluded left anterior descending coronary artery. Thus, ST elevation during exercise testing, although ...
Electrocardiograms were recorded during and at 2-min intervals following maximal treadmill exercise in 100 patients and were correlated with coronary arteriograms, left ventricular cineangiograms, and resting and exercise cardiac hemodynamics. The incidence and extent of exercise-induced "ischemic" S-T segment depression increased significantly (P , 0.01) with increasing extent of coronary artery disease (CAD). A criterion of abnormality of 1.0 mm or greater S-T depression most accurately predicted the presence of CAD with a specificity (true negative) of 89% and a sensitivity (true positive) of 62%. Criteria of ≧0.75 and ≧0.5 mm S-T depression offered improved sensitivities (68 and 84%, respectively) but markedly reduced specificities (78 and 57%, respectively).. A significant correlation (P , 0.005) was found between increasing extent of exercise-induced S-T segment depression and the pulmonary artery wedge pressure during exercise. There were no correlations between the presence or extent ...
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INTRODUCTION: A treadmill exercise test requiring a low initial metabolic rate that then increments the work rate linearly to reach the subjects limit of tolerance in approximately 10 min would have significant advantages for exercise testing and rehabilitation of subjects with impaired exercise tolerance. METHODS: We developed such a treadmill protocol that uses a linear increase in walking speed coupled with a curvilinear increase in treadmill grade to yield a linear increase in work rate. RESULTS: Twenty-two healthy, sedentary subjects performed both this new treadmill protocol and a standard cycle ergometry ramp protocol eliciting similar work rate profiles. The low initial treadmill speed and grade resulted in a low initial metabolic rate, commensurate with unloaded pedaling on a cycle ergometer (average [OV0312]O2 = 0.54 +/- 0.16 vs 46 +/- 0.12 l x min(-1)). This combination of simultaneous increase in speed and grade yielded a linear work rate and its oxygen uptake response (R2 = 0.96 ...
Left atrial volume (LAV) and exercise capacity are important prognostic determinants of cardiovascular risk. Exercise intolerance and increased LAV are expected in patients with diastolic dysfunction. While dyspnea is the symptom reported by the patient and considered subjective, exercise capacity obtained by exercise testing provides an objective measure of cardiovascular fitness. The objective of this study is to determine the relationship between LAV index and exercise capacity in patients with isolated diastolic dysfunction who presented with exertional dyspnea. We studied consecutive patients with dyspnea who underwent treadmill exercise testing and transthoracic echocardiography on the same day. LAV was assessed using the biplane area-length method. Symptom-limited exercise testing was performed immediately after echocardiography. Patients with coronary artery disease, valvular or congenital heart disease, left ventricular systolic dysfunction, pulmonary hypertension or positive exercise test were
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The exercise stress test is a useful screening tool for the detection of significant coronary artery disease. Documentation of the patients symptoms, medications, past and current significant illnesses, and usual level of physical activity helps the physician determine if an exercise stress test is appropriate. The physical examination must include consideration of the patients ability to walk and exercise, along with any signs of acute or serious disease that may affect the test results or the patients ability to perform the test. The test report contains comments about the maximal heart rate and level of exercise achieved, and symptoms, arrhythmias, electrocardiographic changes and vital signs during exercise. This report allows the clinician to determine if the test was
TY - JOUR. T1 - Manipulating graded exercise test variables affects the validity of the lactate threshold and VO2peak. AU - Jamnick, Nicholas A. AU - Botella, Javier. AU - Pyne, David B. AU - Bishop, David J. PY - 2018. Y1 - 2018. N2 - BACKGROUND: To determine the validity of the lactate threshold (LT) and maximal oxygen uptake ([Formula: see text]) determined during graded exercise test (GXT) of different durations and using different LT calculations. Trained male cyclists (n = 17) completed five GXTs of varying stage length (1, 3, 4, 7 and 10 min) to establish the LT, and a series of 30-min constant power bouts to establish the maximal lactate steady state (MLSS). [Formula: see text] was assessed during each GXT and a subsequent verification exhaustive bout (VEB), and 14 different LTs were calculated from four of the GXTs (3, 4, 7 and 10 min)-yielding a total 56 LTs. Agreement was assessed between the highest [Formula: see text] measured during each GXT ([Formula: see text]) as well as between ...
Saunas have been associated with increases in heart rate, changes in systolic blood pressure and ventricular ectopy. Electrocardiographic (ECG) changes have also been noted after patients have been exposed to the supraphysiologic temperatures in a sauna (usually greater than 80°C [176°F]). Giannetti and colleagues conducted a study to determine whether sauna use was well tolerated in patients with stable coronary artery disease (CAD).. Patients with known CAD, exercise-induced ST segment depression and reversible perfusion defects (on technetium-99m sestamibi scans) were included. Patients were excluded if they had a history of myocardial infarction, unstable angina or angioplasty within the previous three months.. Patients with heart failure, uncontrolled hypertension or ventricular arrhythmias were also excluded. The study consisted of three visits. At one visit patients underwent a symptom-limited exercise stress test and nuclear scintigraphy. In the exercise stress test, time to at least 1 ...
Preoperative anaemia and low exertional oxygen uptake are both associated with greater postoperative morbidity and mortality. This study reports the association among haemoglobin concentration ([Hb]), peak oxygen uptake ( peak) and anaerobic threshold (AT) in elective surgical patients. Between 1999 and 2011, preoperative [Hb] and cardiopulmonary exercise tests were recorded in 1,777 preoperative patients in four hospitals. The associations between [Hb], peak and AT were analysed by linear regression and covariance. In 436 (24.5%) patients, [Hb] was |12 g dl-1 and, in 83 of these, |10 g dl-1. Both AT and
The current outpatient evaluation for angina in low and intermediate risk patients typically starts with a functional assessment for coronary ischemia. Exercise treadmill testing is often selected as the initial diagnostic modality for coronary artery function. However, exercise treadmill testing is limited by its moderate sensitivity and specificity, often resulting in further cardiac resource utilization for patient risk stratification and reassurance. With the advent of coronary multislice computed tomography (MSCT) angiography, coronary artery anatomy can now be evaluated noninvasively. Despite its impressive performance characteristics, the role of coronary MSCT angiography in the outpatient evaluation of angina remains undefined.. CT-EXTRA compares the impact on patient safety and downstream resource utilization of a novel initial diagnostic strategy employing the addition of coronary MSCT angiography to exercise treadmill testing with a standard diagnostic strategy of exercise treadmill ...
http://www.translational-medicine.com/content/12/1/20/abstract Decreased oxygen extraction during cardiopulmonary exercise test in patients with...
OBJECTIVES: The purpose of this study was to determine the antihypertensive agent(s) more likely to mitigate an exaggerated rise in exercise blood pressure (BP) in hypertensive patients. BACKGROUND: An exaggerated rise in exercise BP is associated with increased cardiovascular risk. There are no recommendations for treating such response. METHODS: Participants were hypertensive men (n = 2,318; age 60 +/- 10 years), undergoing a routine exercise test at the Veterans Affairs Medical Center, Washington, DC. Antihypertensive therapy included angiotensin-converting enzyme inhibitors (n = 437), calcium-channel blockers (n = 223), diuretics (n = 226), and combinations (n = 1,442), beta-blockers alone (n = 201) or in combination with other antihypertensive agents (n = 467), and none (n = 208). Exercise BP, heart rate (HR) and rate-pressure product (RPP) at maximal and submaximal workloads were assessed. RESULTS: After adjusting for covariates, patients treated with beta-blockers or beta-blocker-based ...
Introduction. Considerable doubt remains about whether the warm-up effect in angina represents ischaemic preconditioning (IPC), or is simply due to improved myocardial perfusion via acute recruitment of collaterals. We investigated the latter possibility using quantitative tetrofosmin SPECT. Methods. 11 patients (age 63±8 years, 8 male) with coronary disease and preserved left ventricular function underwent symptom-limited treadmill exercise off antianginal medication. On three separate days at weekly intervals, 99m Tc-tetrofosmin 400-450MBq was injected at rest, during a single exercise test (Ex1), and during the second of two exercise tests separated by 30 minutes (Ex2a and Ex2b). Exercise injections were given at equivalent heart rates. SPECT acquisitions were obtained 1-2 hours after each tetrofosmin injection. Quantitative analysis was performed by comparing polar plots derived from radial slices with a normal database. The hypoperfusion index was the product of
Objectives: To assess the association between impaired chronotropic response (CR) and adverse events among patients with diabetes referred for exercise treadmill testing (ETT).. Research design and methods: Impaired CR was defined as achievement of less than 80% of a patients heart rate reserve. Multivariable Cox proportional hazards regression assessed the independent association between impaired CR and adverse outcomes adjusting for demographics, co-morbidities and treadmill variables including the Duke Treadmill score.. Results: Of 1,341 patients with diabetes, 35.7% (n=479) demonstrated impaired CR during ETT. Patients with impaired CR were at increased risk of all-cause mortality, myocardial infarction, or coronary revascularization procedures. In multivariable analyses, impaired CR remained significantly associated with adverse outcomes (HR 1.53; 95% CI 1.10-2.14).. Conclusions: Among patients with diabetes, impaired CR is common during ETT and is associated with adverse outcomes. ...
is known from exercise testing, as opposed to estimating target heart rate or work rate from age-predicted calculations. In addition, in cases where ischemia or arrhythmias are induced at higher exercise intensities, exercise test results could be used to keep exercise intensity below the ischemic threshold. Exercise testing also can be useful for risk stratification, given that lower aerobic capacity (27) and the presence of ischemic changes on ECG (28) are each associated with higher risks of cardiovascular and overall morbidity and mortality. Exercise testing can also sometimes detect previously unsuspected coronary disease. However, no trial has specifically assessed whether exercise stress testing before beginning an exercise program reduces coronary morbidity or mortality. Furthermore, a recent randomized trial found that screening of asymptomatic people with diabetes and additional cardiac risk factors using exercise ECG stress testing (or dipyridamole single photon emission computed ...
We have shown that, in patients with permanent AF with a mixed ventricular response rate, improved rate control will lead to a significant improvement in exercise duration and quality of life with equal preservation of a normal left ventricular function. However, rate regulation by ablation conferred no additional benefit compared to rate control alone in this patient group.. Patients with permanent AF often complain of limited exercise capacity and breathlessness despite a normal left ventricular function. In these patients assessment of ventricular rate control must be done thoroughly. Reliance on the ventricular rest rate at clinic visits is inadequate, as it gives no indication of the heart rate response to exercise. In this study the resting heart rate prior to exercise in the medical group did not significantly change from baseline at any follow up. However, at baseline there was poor rate control evident on exercise testing. Therefore assessment for rate control should include exercise ...
Nuclear stress test utilizes nuclear isotope (most commonly Cardiolite) which traces blood flow to the heart. This nuclear tracer in the blood is taken up by heart muscle in proportion to coronary blood flow, i.e., normal uptake if the flow is intact and less uptake if the flow is reduced due to coronary blockage. This blood flow pattern is shown by nuclear camera which scans the small amount of radioactivity emitted by the isotope taken up by heart tissue. Hence the test is primarily designed to detect signs of coronary artery disease. This isotope is well-tolerated by most and is cleared from the body in 24 to 36 hours.. This is carried out in two parts: stress images and resting images. The stress part can be done with treadmill stress test or "chemical" stress test (most commonly Lexiscan or Persantine) if you cannot physically exercise. At peak exercise or following injection of Lexiscan, Cardiolite is injected and the patient is scanned under the nuclear camera. The resting images are also ...
HealthDay News) - For adult survivors of childhood acute lymphoblastic leukemia (ALL), exercise intolerance is associated with worse neurocognitive outcomes, according to a study published online Oct. 21 in Cancer.. Nicholas S. Phillips, M.D., Ph.D., from St. Jude Research Hospital in Memphis, Tennessee, and colleagues obtained cardiopulmonary exercise test results, results from a two-hour standardized neuropsychological assessment, and self-report questionnaires for 341 adult survivors of childhood ALL and 288 controls. The authors examined the correlations between oxygen uptake at 85 percent estimated heart rate (rpkVO2) and neurophysiological test and self-reported questionnaire domains.. The researchers found that survivors had worse rpkVO2 and performance on verbal intelligence, focused attention, verbal fluency, working memory, dominant/nondominant motor speed, visual-motor speed, memory span, and measures of reading and math than controls. In survivors, exercise intolerance correlated ...
Nuclear Medicine Myocardial Perfusion Imaging Stress and Resting Studies with Ejection Fraction and Wall ___ Treadmill Exercise - CPT 93015 † ___ Pharmacological - CPT 93015 † ❑ Nuclear Medicine Myocardial Perfusion Imaging Stress or Resting Study with Ejection Fraction and Wall ___ Treadmill Exercise - CPT 93015 † ___ Pharmacological - CPT 93015 † ❑ 730.00 Acute Osteomyelitis❑ 213.9 Benign Neoplasm Bone NOS ❑ Treadmill Stress Test (No Imaging) - CPT 93015 ❑ Other ________________________________________ ❑ 12 Lead ECG - CPT 93000 †❑ MUGA / Ejection Fraction - CPT 78472 † Thyroid Scan and Uptake - CPT 78006 ❑ Thyroid Uptake Only (No Scan) - CPT 78000❑ 241.9 Nontoxic Nodular Goiter NOS Please select the appropriate ICD9 code below ❑ Other ________________________________________ ❑ Renal Scan and Vascular Flow - CPT 78701 ___ with Lasix - ❑ Single Study - CPT 78708___ with Captopril - ❑ Multiple Study - CPT 78709 PET / CT (Available at Stillwell Avenue, Bond ...
Computer-assisted interpretation of the exercise electrocardiogram has been advocated to improve the accuracy of diagnosing coronary artery disease. Its accuracy was compared with a blinded visual interpretation of exercise-induced ST depression in 271 consecutive subjects without prior myocardial infarction who were referred for coronary angiography. The sensitivity of the visual and computer readings was 0.51 and 0.51, respectively, at a specificity of 0.87. Receiver operating characteristic curves were generated for the visual and computer ST depression in lead V5. Analysis of the areas under these curves showed no significant difference between them, indicating that computer-assisted analysis was not superior to unmodified visual analysis. A similar analysis was applied to two other computer indexes reported to be superior to visual assessments (treadmill exercise score and ST index). These computer indexes were not superior to a conventional visual analysis of leads I, II, V2, V4and V5in ...
Exercise is a common physiology stress used to elicit cardiovascular abnormalities not present at rest and to determine the adequacy of cardiac function. Tread Mill Test (TMT) is one of the most frequent non invasive modalities used to assess patients with suspected or proven CAD. The test is mainly used to estimate prognosis and to determine functional capacity, the likelihood and extent of CAD, and the effects of therapy. The treadmill protocol should be consistent with the patients physical capacity and the purpose of the test. The Bruce multistage maximal treadmill protocol has 3-minute periods to allow achievement of a steady state before work-load is increased. In older individuals or those whose exercise capacity is limited by Cardiac Disease, the protocol can be modified by two 3-minute warm-up stages. The sensitivity of the Tread Mill Test (TMT) in patients with CAD is approximately 68%, and specificity is 77%. The exercise electrocardiography (ECG) result is more likely to be abnormal ...
Both poor cardiorespiratory fitness (CRF) and fasting blood triglyceride to high-density lipoprotein cholesterol ratio (TG:HDL-C) are significantly associated with coronary heart disease (CHD) in men, with the risk of CHD significantly attenuated in men with moderate to high CRF compared with men with low CRF. This according to a study of 40,269 men who received a comprehensive baseline clinical examination between January 1, 1978 and December 31, 2010 with CRF determined from a maximal treadmill exercise test.
Both poor cardiorespiratory fitness (CRF) and fasting blood triglyceride to high-density lipoprotein cholesterol ratio (TG:HDL-C) are significantly associated with coronary heart disease (CHD) in men, with the risk of CHD significantly attenuated in men with moderate to high CRF compared with men with low CRF. This according to a study of 40,269 men who received a comprehensive baseline clinical examination between January 1, 1978 and December 31, 2010 with CRF determined from a maximal treadmill exercise test.
The Body Rider BRF700 Fan Upright Exercise Bike is overall a very good choice for anyone looking for a straightforward exercise bike. Convenience and versatility are the two words that best encompasses the Body Rider BRF700 Fan Upright Exercise Bike.. Without the whistles and bells of more expensive machines, the Body Rider BRF700 Fan Upright Exercise Bike still delivers an impactful and intense workout. Small in size, the Body Rider BRF700 Fan Upright Exercise Bike can be placed anywhere in your home making it a suitable choice for those who live in an apartment or for those who want to add an exercise machine in a tighter space.. With its unique duo handlebar technology, the Body Rider BRF700 Fan Upright Exercise Bike targets your midsection and upper body as well as your lower body. An additional feature is the fan wheel which provides a gentle cooling breeze so you never feel uncomfortable while enjoying a nice rigorous workout.. While some users have complained that the bike does not fit ...
My 61 years old father-in-law weighs 72 kg. His recent blood pressure report reads 130/80 mmHg. |b|He has been suffering from chest pain, which moves towards his jaws and then the jaws get tightened|/b|. Fearing a heart problem, we got various tests done and the treadmill stress test reported: normal B response, no chest pain, good effort tolerance but the test was positive for inducible ischaemia. What does it mean? Does he need to go for an angiography and then an angioplasty? How much do these treatments cost?
Among patients with unprotected left main coronary artery disease undergoing elective revascularization, there was no difference in two of the three primary endpoints, angina status or duration on treadmill stress test, between the stent and CABG treated patients, but LVEF was slightly higher in the PCI group. However, the trial has numerous limitations, including three "primary" endpoints; standard clinical trial methodolgy entails using one primary endpoint. Additionally, there was no statistical adjustment for multiple endpoints. The rate of infection following CABG was extremely high (13% during the first month), compared with a reported rate of ~3% in recent CDC reports. The presenters did not provide information on why the rate was higher than historical data. Additionally, the rate of repeat revascularization during the first year in the surgical group was 15%, much higher than historical data of ~4%, particularly given the fact that 79% of patients in the trial were treated with LIMAs, ...
We describe a case that illustrates the great value of the lateral view in this scenario. The history is that of a 62 year old lady with typical angina and a positive exercise treadmill test during Stage 3. She was admitted and underwent cardiac catheterisation. Angiography of the left coronary artery was normal. The RCA was then imaged and Images 1 to 3 show the standard views. The LAO view is unremarkable; however, the LAO cranial and RAO views create some uncertainty about adequate engagement of the ostium but no definite lesion was identified. There was some damping and the operator moved to the right lateral view. Image 4 clearly shows a critical lesion at the ostium of the RCA and delineates the anatomy in relation to the length of disease and relation to the aortic wall. The patient proceeded to definitive intervention and Images 5 to 10 clearly demonstrate the critical importance of the right lateral view in facilitating the accurate positioning and implantation of a stent covering the ...
Background: This study examined the associations of body mass index (BMI), waist circumference (WC), and cardiorespiratory fitness (CRF) with incident functional limitation (IFL) in adults. Methods: Patients (n = 2400), 30+ years [mean age, 45.2 (SD, 8.3); 12% women], completed a baseline health examination during 1979 to 1995. CRF was quantified by age- and sex-specific thirds for maximal treadmill exercise test duration. Adiposity was assessed by BMI and WC (grouped for analysis according to clinical guidelines). Incident IFL was identified from mail-back surveys during 1995, 1999, and 2004. Results: After adjusting for potential confounders and either BMI or WC, CRF was inversely related to IFL (P trend |.001). The association between BMI and IFL was significant after adjusting for all confounders (P trend = .002), but not after additional adjustment for CRF (P trend = .23). After controlling for all confounders and CRF, high WC was associated with greater odds of IFL in those aged 30 to 49; normal
By Bob Hobbs, APRN, MBA. With Healthcare reform focusing on more preventative services we wanted to discuss a diagnostics/screening test that has been around for years. The stress test was developed in 1928 and has been used since 1929 to help diagnose and screen patients with various heart related problems. It has evolved into a cardiac investigative test. Technological improvements over the years have led to the decrease in costs of performing this test which makes it available to more facilities. Patients are being screened now at the primary care level. In this article we will discuss the basics of a cardiopulmonary exercise stress test (CPET), discuss how the results of the test are used, and which patients should be asking their provider more about this test.. What is the CPET Stress Test?. While there are several types of stress tests that are performed such as a Dobutamine or Adenosine Stress Test (chemical stress test for those patients unable to exercise), stress echocardiogram, and ...
BACKGROUND: A reference set of data of normal values of newly developed cardiopulmonary parameters of exercise testing in an 8-18-year-old population is lacking. PATIENTS AND METHODS: Cardiopulmonary exercise testing was performed in 175 healthy school children (8-18 years old). Continuous electrocardiography was performed, and minute ventilation, oxygen uptake (VO2), and ... read more carbon dioxide (CO2) production were measured continuously with a respiratory gas analysis system. RESULTS: Peak VO2/kg did not change with age, whereas the ventilation to carbon dioxide exhalation slope was lower in the older children. The decline in heart rate during recovery was much faster in the youngest children. Linear regression analysis showed a significant effect of age on: peak work rate (WRpeak) and WRpeak/kg, ventilation to carbon dioxide exhalation slope, heart rate recovery, and VO2peak (boys only) (All P , 0.001). The ΔVO2/ΔWR slope remained constant throughout all age groups. CONCLUSION: This ...
Participants received a comprehensive medical evaluation including history, physical examination, blood chemistries, graded exercise treadmill test with measurement of maximal aerobic capacity (Vo2max), and an oral glucose tolerance test. Resting BP and fasting lipids and glucose were assessed while participants were taking their routine medications. Clinical assessment of BP was performed on 2 to 3 occasions with patients in a seated position using an automated vital signs monitor (Dinamap Model 1846SX; Critikon) and appropriate sized occluding cuff. Readings were averaged to yield an estimate of participants resting clinic systolic and diastolic BPs. Total plasma cholesterol and glucose levels were determined enzymatically.. On a separate day, participants completed a psychophysiological assessment. Persons taking antihypertensive medications had them withdrawn under medical supervision for 2 weeks (,5 half-lives) before this visit. During the session, BP was monitored while subjects engaged ...
What did you do?. Adults with CF were asked to complete two exercise sessions in which cardiorespiratory variables such as heart rate and shortness of breath were measured. The first session involved participants cycling on an exercise bike until they could no longer continue (a cardiopulmonary exercise test - CPET). This allowed us to measure each participants peak exercise capacity. The second session involved 20 minutes of exercise using a personal training program for Xbox Kinect. ...
Most guidelines recommend a systematic screening of asymptomatic high risk patients with diabetes for silent ischemia, but the clinical benefit of this strategy has not been demonstrated compared with the simple control of cardiovascular risk factors. We sought to determine whether referring asymptomatic diabetic patients for screening of silent ischemia decreases the risk of cardiovascular events compared with usual care. DYNAMIT was a prospective, randomized, open, blinded end-point multicenter trial run between 2000 and 2005, with a 3.5 year mean follow-up in ambulatory care in 45 French hospitals. The study included 631 male and female with diabetes aged 63.9 ± 5.1 years, with no evidence of coronary artery disease and at least 2 additional cardiovascular risk factors, receiving appropriate medical treatment. The patients were randomized centrally to either screening for silent ischemia using a bicycle exercise test or Dipyridamole Single Photon Emission Computed Tomography (N = 316), or follow-up
Last Feb 05, I developed the flu and had a horrendous cough, I continually coughed until I became nauseous at times. My chest felt like someone punched me in the chest, expecially around my Xyphoid process and on the sides of my sternum. The pain became so intense that I went to the ER at the Heart Hospital. After spending time there and being admitted to the telemetry unit overnite, I had a treadmill stress test in the morning. I was told I had nothing to worry about. The pain persisted. A doctor prescribed Darvocet N-100 two tabs Q8 hours prn. All I wanted to do was sleep and did so 16-18 hour/day. I went back and was prescribed Xanax 1 mg thinking it was spasm and Nitro gave me intense headaches. That did not work. I went back and my Xyphoid process was injected with cortisone and an anesthetic and also 2 intercostal areas. No effect ...
Question - Had Positive Stress Test for Induced Ischemia. Can I postpone Angiogram?. Ask a Doctor about diagnosis, treatment and medication for Left ventricular hypertrophy, Ask a Cardiologist
Cikrytova, E., Kostelecka, B., Kovar, J., Horak, F. and Hanak, J. (1991) Standardized exercise test on a track to evaluate exercise capacity in different breeds of horses. In: Equine Exercise Physiology 3, Eds: S.G.B. Persson and L.B. Jeffcott, ICEEP Publications, Davis, California. pp 37-40 ...
AIMS: Cardiopulmonary exercise test (CPET) is used to evaluate patients with chronic heart failure (HF) usually by means of a personalized ramp exercise protocol. Our aim was to evaluate if exercise duration or ramp rate influences the results. METHODS AND RESULTS: Ninety HF patients were studied (peak V (O(2)): ,20 ml/min/kg, n=28, 15-20 ml/min/kg, n=39 and ,15 ml/min/kg, n=23). Each patient did four CPET studies. The initial study was used to separate the subjects into three groups, according to their exercise capacity. In the remaining studies, work-rate was increased at three different rates designed to have the subjects reach peak exercise in 5, 10 and 15 min from the start of the ramp increase in work-rate, respectively. The order was randomized. The work-rate applied for the total population averaged 22.7+/-8.0, 11.6+/-3.7, 7.5+/-2.9 W/min with effective loaded exercise duration of 5 min and 16 s+/-29 s, 9 min and 43 s+/-49 s and 14 min and 32 s+/-1 min and 12 s for the 5-, 10- and 15-min ...